| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| USI INSURANCE SERVICES LLC2 | UNKNOWN VIRGINIA BEACH, VA 23466 | PRUDENTIAL INSURANCE COMPANY OF AMERICA | $11K | $0 | $11K | 2.57% |
| IMG5 | 2960 NORTH MERIDIAN STREET INDIANAPOLIS, IN 46208 | PRUDENTIAL INSURANCE COMPANY OF AMERICA | $0 | $183 | $183 | 0.04% |
| USI INSURANCE SERVICES LLC3 | PO BOX 62937 VIRGINIA BEACH, VA 23466 | VISION SERVICE PLAN | $3K | $0 | $3K | 2.49% |
| USI INSURANCE SERVICES LLC3 | PO BOX 62937 VIRGINIA BEACH, VA 23466 | UNUM INSURANCE COMPANY | $3K | $712 | $4K | 14.69% |
| USI INSURANCE SERVICES LLC3 | 75 JOHN ROBERTS ROAD BUILDING G SOUTH PORTLAND, ME 04106 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $6K | $0 | $6K | 25.18% |
| USI INSURANCE SERVICES LLC3 | 12 GILL STREET, SUITE 5500 WOBURN, MA 01801 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $51 | $0 | $51 | 0.21% |
| USI INSURANCE SERVICES LLC3 | 12 GILL STREET, SUITE 5500 WOBURN, MA 01888 | FEDERAL INSURANCE COMPANY | $214 | $23 | $237 | 16.63% |
| USI INSURANCE SERVICES LLC3 | 12 GILL STREET, SUITE 5500 WOBURN, MA 01801 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $20 | $0 | $20 | 4.03% |
No Schedule C service providers reported on this filing.
Benefits declared on the Form 5500 main form (✓ = also has a Schedule A insurance contract; otherwise the benefit is funded out of plan assets or via a Schedule C TPA).
The plan reports several different headcounts depending on which form you read. Each one measures a different slice of the population.
| Active participants | 837 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 8 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 845 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Vision | VISION SERVICE PLAN | 571 | $133K |
| Life insurance | PRUDENTIAL INSURANCE COMPANY OF AMERICA | 837 | $434K |
| Long-term disability(2 contracts, 2 carriers) | PRUDENTIAL INSURANCE COMPANY OF AMERICA | 837 | $458K |
| Other(5 contracts, 5 carriers) | PRUDENTIAL INSURANCE COMPANY OF AMERICA | 837 | $486K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 837 | — |
Why the numbers differ. Form 5500 line 6 counts employees + retirees + beneficiaries; no dependents. Schedule A persons-covered counts everyone enrolled, including spouses and children, so it usually exceeds line 6 by 30-60% on a working-age workforce. The medical row is normally the broadest single line because it has the highest take-up; dental/vision/life often dip below it. Stop-loss / reinsurance contracts sometimes report the carrier's full underwriting pool rather than this filer's headcount; the row is shown for transparency but shouldn't be read as "people in this plan."
Schedule A presence shifted between filings (insured ↔ self-funded, or new contracts added/removed). Capture the transition window.